Crown Lengthening Surgery for Treating Asymmetric Gingiva: A Case Report


Background: The aesthetic appearance of gingiva is influenced by color, contour, interdental papilla and location of gingival margin. Crown lengthening is one of the surgical procedures performed to improve aesthetic problems. It can be performed by gingivectomy, with or without alveolar bone removal (osteotomy) to obtain a good crown and root ratios.

Objective: To obtain better crown and root ratios, resulting in more aesthetic smile.

Case Report: A 24-year-old woman presented with a complaint that the length of her anterior maxilla teeth was different. Extraoral examination showed a symmetric face with no abnormalities and the patient did not have a systemic disease. Intraoral examination showed that the gingival margins between teeth 11 and 21 was asymmetric, consistency of the gingiva was normal, there was no sign of inflammation and the pocket depth was 2–3 mm. The patient was given scaling in the first phase, and then the alignment of gingival margins of teeth 11–13 with teeth 21–23 was measured. Gingivectomy was performed on teeth 21–23 using scalpel no. 11, gingival contour was formed and the periodontal pack was applied.

Results: The patient reported no complaints at the one-week follow-up and the gingival margin looked symmetrical one-month post-surgery.

Conclusion: Crown-lengthening surgery with a gingivectomy procedure gives a good aesthetic result, in this case, characterized by a symmetrical gingival margin.

Keywords: crown lengthening, gingivectomy, gingival aesthetics

[1] Dholey MK, Sinha S, Kole D, Sen S. The crown lengthening surgery: Two case reports. Asian Pacific Journal of Health Sciences. 2018;5(4):23-26.

[2] Pedraza JAQ, Salinas BRG, Fierro NC, Nájera RIS, Treviño JJF, Delgado IR. Crown lengthening procedure using aesthetic measurement gauges: A case report. International Journal of Applied Dental Sciences. 2017;3(2):95–97.

[3] Koppolu P, Kalakonda B, Mishra A, et al. Smile correction using an esthetic crown lengthening with either diode laser or scalpel – A comparative clinical patient perspective study. British Journal of Medicine and Medical Research. 2017;19(4):1–9.

[4] Melnick PR, Takei HH. Preparation of the periodontium for restorative dentistry. Newman and Carranza’s Clinical Periodontology. 13th ed. Newman MG, Takei HH, Klokkevold PR, editors. Philadelphia: Elsevier; 2019.

[5] Seixas MR, Costa-pinto RA, Araújo TM. Gingival esthetics: An orthodontic and periodontal approach. Dental Press Journal of Orthodontics. 2012;17(5):190–201.

[6] Allen EP. Use of mucogingival surgical procedures to enhance esthetics.

[7] Dental Clinics of North America. 1988;32(2):307–330.

[8] Ardakani MRT, Khalilian F, Nateghi Z, Esmaeilnejad A, Janbakhsh N. A review of the crown lengthening surgery: The basic concepts. British Journal of Medicine and Medical Research. 2016;13(3): 1–7.

[9] Gupta G, Gupta R, Gupta N, Gupta U. Crown lengthening procedures - A review article. IOSR Journal of Dental and Medicinal Sciences. 2015;14(4):27-37.

[10] Oliveira PS, Chiarelli F, Rodrigues JA, et al. Aesthetic surgical crown lengthening procedure. Case Reports in Dentistry. 2015;2015:1-4.

[11] Milavec S, Gaspirc B. Case report: Clinical crown lengthening: Laser-assisted versus conventional surgical therapy. Journal of the Laser and Health Academy. 2014;1:42- 44.

[12] Lee EA. Aesthetic crown lengthening: Classification, biologic rationale, and treatment planning considerations. Practical Procedures and Aesthetic Dentistry. 2004;16(10):769-778.

[13] Assaf M. Esthetic crown lengthening for upper anterior teeth: Indications and surgical techniques. International Journal of Dental and Medical Research. 2014;1(3):86-91.