Crown Lengthening for Obtaining Biological Width in Dental Restoration: A Case Report
Background: Biological width is a natural defensive space for periodontal tissue which is important for maintaining healthy periodontal tissue so that it can support the success of dental restoration treatment. The localized alveolar bone loss, gingival recession, localized gingival hyperplasia or a combination of all three can be caused by poor biological width restoration. Biological width is obtained through crown lengthening when restoration of teeth have caries or subgingival fractures under the gingival attachment. The crown-lengthening procedure is performed to increase the height of the clinical crown for restoring and improving the esthetics of the teeth.
Objective: This case report presents two cases of crown lengthening with osteotomy before the dental restoration procedure.
Case Report: The first case was of a 43-year-old woman who was referred from the prosthodontics clinic RSKGM FKG UI before making permanent restorations on tooth 13. Clinical examination showed red gums, swelling and caries that extended to subgingival especially in the distal part. A crown-lengthening procedure with an osteotomy was performed distally to increase the height of the clinical crown so that it had a good ferrule effect for the restoration of the tooth. The second case was of a 25-year-old female patient who had undergone root canal treatment by a general dentist. The clinical appearance of the tooth showed an imbalance in the height of the gingival zenith with the tooth next to it, and the clinical crown looked short. Crown lengthening with osteotomy was done to get a balanced zenith height.
Conclusion: Crown lengthening is a periodontal surgical treatment performed to obtain optimum biological width to support tooth restoration.
Keywords: crown lengthening, osteotomy, biological width
 Lanning SK, Waldrop TC, Gunsolley JC, Maynard JG. Surgical crown lengthening: Evaluation of the biological width. J Periodontol. 2003;74(4):468–74.
 Humagain M, Rokaya D, Sri R, Dixit S, Kafle D. Gender based comparison of gingival zenith esthetics. Kathmandu Univ Med J. 2016;14(54):148–52.
 Devapriya Appukuttan, Priyanka K. Cholan CRA, Swapna S. Assessment of gingival zenith position and distance from vertical bisecting midline in the maxillary anterior dentition − An observational study abstract. J Orofac Sci. 2018;10( Jul):14–8.
 Parashar A, Zingade A. Biological width: The silent zone. 2015;2(4):11–6.
 Nautiyal A, Gujjari S, Kumar V. Aesthetic crown lengthening using Chu aesthetic gauges and evaluation of biologic width healing. J Clin Diagnostic Res. 2016;10(1):ZC51–5.
 Quiñones JA, Salinas RG, Fierro C et al. Crown lengthening procedure using aesthetic measurement gauges: A case report. Int J Appl Dent Sci. 2017;3(2):95– 7.
 Gupta G, Gupta R, Gupta N, Gupta U. Crown lengthening procedures- A review article. 2015;14(4):27–37.
 Hempton TJ, Dominici JT. Contemporary crown-lengthening therapy: A review. J Am
 Dent Assoc. 2010;141(6):647–55. http://dx.doi.org/10.14219/jada.archive.2010.0252
 Schmidt JC, Sahrmann P, Weiger R, Schmidlin PR, Walter C. Biologic width dimensions - A systematic review. J Clin Periodontol. 2013;40(5):493–504.
 Thomas S, Sampat P, Agarwal S, Prabhu A, Pathak T. Biologic width – Exploring the mystery of a silent zone. 2018;17(12):38–45.
 Marzadori M, Stefanini M, Sangiorgi M, Mounssif I, Monaco C, Zucchelli G. Crown lengthening and restorative procedures in the esthetic zone. Periodontol 2000. 2018;77(1):84–92.
 Pham HT, Nguyen PA, Pham TAV. Periodontal status of anterior teeth following clinical crown lengthening by minimally traumatic controlled surgical extrusion. Dent Traumatol. 2018;34(6):455–63.
 Dholey MK, Sinha S, Kole D, Sen S. The crown lengthening surgery two case reports. Asian Pacific J Heal Sci. 2018;5(4):23–6.
 Oh SL. Biologic width and crown lengthening: Case reports and review. Gen Dent. 2010;58(5).
 Amin WM, Al-Huniti NS, Hasan NI, Al-Nimri DW, Al-Najdawi SA. Effect of ferrule location on fracture resistance and failure pattern of endodontically treated maxillary incisors restored with quartz fiber posts. 2013;4(Sept):343–52.
 Bennani V, Ibrahim H, Al-Harthi L, Lyons KM. The periodontal restorative interface: Esthetic considerations. Periodontol 2000. 2017;74(1):74–101.
 Konikoff BM, Johnson DC, Schenkein HA, Kwatra N, Waldrop TC. Clinical crown length of the maxillary anterior teeth preorthodontics and postorthodontics. J Periodontol. 2007;78(4):645–53. DOI