Dentaltown February 2018 - 76
Functional Osseous
Crown Lengthening:
A Primer
by Dr. Brian S. Gurinsky
Dr. Brian S. Gurinsky was born in
Dallas and attended college at the
University of Texas at Austin. He
continued his education at Baylor
College of Dentistry in Dallas,
where he obtained his Doctor of
Dental Surgery.
After graduation, Gurinsky
began a three-year residency in
periodontics and dental implants, and earned his certificate
in periodontics from the University of Texas Health Science
Center in San Antonio. He has private practices in Denver and
Centennial, Colorado.
76
FEBRUARY 2018 // dentaltown.com
How do you
know if you
need to lengthen
a crown?
This piece will focus on crown lengthening for functional reasons only-stay tuned
for a future installment about possible aesthetic reasons.
"Many practitioners never crown-lengthen teeth, so why do I need to bother?" you
may be asking. This added procedure will certainly add cost and healing time to a
patient's treatment plan, but there are some fundamental reasons why certain teeth will
need to be crown-lengthened.
More surface needed!
The fi rst reason to crown-lengthen a
tooth is if there simply isn't enough clinical
crown remaining to receive a crown. A
patient who has occlusal wear may have
lost enough occlusal tooth structure so that
by the time the tooth is prepped, there isn't
enough axial height to retain the crown.
Every practitioner has his or her comfort
zone; my rule of thumb is to have at least
4 millimeters of axial height to support a
crown. Obviously, luting agents have evolved
and we often can get away with less, but I
shoot for a minimum of 4mm.
Anatomically, there are also going to be
areas in the mouth where excess tissue will
lead to short clinical crowns. Second molars
are commonly shorter as a result. Have you
ever run into that situation where by the
time you prep #31, the tooth is just so short
that the crown keeps coming uncemented?
In such scenarios, we usually need to
crown-lengthen 360 degrees or close to it.
But there are also other situations where
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown February 2018
Dentaltown February 2018 - Intro
Dentaltown February 2018 - Cover1
Dentaltown February 2018 - Cover2
Dentaltown February 2018 - 1
Dentaltown February 2018 - 2
Dentaltown February 2018 - 3
Dentaltown February 2018 - 4
Dentaltown February 2018 - 5
Dentaltown February 2018 - 6
Dentaltown February 2018 - 7
Dentaltown February 2018 - 8
Dentaltown February 2018 - 9
Dentaltown February 2018 - 10
Dentaltown February 2018 - 11
Dentaltown February 2018 - 12
Dentaltown February 2018 - 13
Dentaltown February 2018 - 14
Dentaltown February 2018 - 15
Dentaltown February 2018 - 16
Dentaltown February 2018 - 17
Dentaltown February 2018 - 18
Dentaltown February 2018 - 19
Dentaltown February 2018 - 20
Dentaltown February 2018 - 21
Dentaltown February 2018 - 22
Dentaltown February 2018 - 23
Dentaltown February 2018 - 24
Dentaltown February 2018 - 25
Dentaltown February 2018 - 26
Dentaltown February 2018 - 27
Dentaltown February 2018 - 28
Dentaltown February 2018 - 29
Dentaltown February 2018 - 30
Dentaltown February 2018 - 31
Dentaltown February 2018 - 32
Dentaltown February 2018 - 33
Dentaltown February 2018 - 34
Dentaltown February 2018 - 35
Dentaltown February 2018 - 36
Dentaltown February 2018 - 37
Dentaltown February 2018 - 38
Dentaltown February 2018 - 39
Dentaltown February 2018 - 40
Dentaltown February 2018 - 41
Dentaltown February 2018 - 42
Dentaltown February 2018 - 43
Dentaltown February 2018 - 44
Dentaltown February 2018 - 45
Dentaltown February 2018 - 46
Dentaltown February 2018 - 47
Dentaltown February 2018 - 48
Dentaltown February 2018 - 49
Dentaltown February 2018 - 50
Dentaltown February 2018 - 51
Dentaltown February 2018 - 52
Dentaltown February 2018 - 53
Dentaltown February 2018 - 54
Dentaltown February 2018 - 55
Dentaltown February 2018 - 56
Dentaltown February 2018 - 57
Dentaltown February 2018 - 58
Dentaltown February 2018 - 59
Dentaltown February 2018 - 60
Dentaltown February 2018 - 61
Dentaltown February 2018 - 62
Dentaltown February 2018 - 63
Dentaltown February 2018 - 64
Dentaltown February 2018 - 65
Dentaltown February 2018 - 66
Dentaltown February 2018 - 67
Dentaltown February 2018 - 68
Dentaltown February 2018 - 69
Dentaltown February 2018 - 70
Dentaltown February 2018 - 71
Dentaltown February 2018 - 72
Dentaltown February 2018 - 73
Dentaltown February 2018 - 74
Dentaltown February 2018 - 75
Dentaltown February 2018 - 76
Dentaltown February 2018 - 77
Dentaltown February 2018 - 78
Dentaltown February 2018 - 79
Dentaltown February 2018 - 80
Dentaltown February 2018 - 81
Dentaltown February 2018 - 82
Dentaltown February 2018 - 83
Dentaltown February 2018 - 84
Dentaltown February 2018 - 85
Dentaltown February 2018 - 86
Dentaltown February 2018 - 87
Dentaltown February 2018 - 88
Dentaltown February 2018 - 89
Dentaltown February 2018 - 90
Dentaltown February 2018 - 91
Dentaltown February 2018 - 92
Dentaltown February 2018 - 93
Dentaltown February 2018 - 94
Dentaltown February 2018 - 95
Dentaltown February 2018 - 96
Dentaltown February 2018 - 97
Dentaltown February 2018 - 98
Dentaltown February 2018 - 99
Dentaltown February 2018 - 100
Dentaltown February 2018 - 101
Dentaltown February 2018 - 102
Dentaltown February 2018 - 103
Dentaltown February 2018 - 104
Dentaltown February 2018 - Cover3
Dentaltown February 2018 - Cover4
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com