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


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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
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Dentaltown February 2018 - Cover3
Dentaltown February 2018 - Cover4
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