The surgical crown lengthening is a procedure, which is probably not performed as often as it should be. There are multiple medical indications for this operation. Not only do we need it for example to modify the red-white aesthetics, but this operation should be done in many other cases. If a patient has too short clinical crowns, which would give not enough retention for restorations we should prepare a more suitable situation by surgical intervention. Especially with ceramic-restorations, which need adhesive attachment, we often have problems. The preparation margin should be supra- or paragingival. This is often not the case, so it is more difficult to have a clean and dry operation area, while attaching the restoration. If we would perform a surgical crown lengthening before preparation, things would be a lot easier afterwards. Last but not least we often have to distort the biological width. This will result in chronically inflamed areas around the restoration. If we know that the defect of the tooth is going to force us to damage the biological width, we have to perform a surgical crown lengthening before starting with the planned treatment. So why is it, that this operation is performed so rarely? The answer is easy to give. The conventional treatment with scalpel, bone milling cutter, needle and thread is not easy, is bloody and risky and often associated with pain for our patients. In addition, we have to wait several weeks for the healing process to end, which will retard the actual treatment. Therefore it is obvious, that many dentists and patients will look for a compromise and will risk functional and/or aesthetic degradation...
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