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Gum Diseases

Cosmetic gum graft over a long crown?

12/18/2005

Question:

Recently I had a very bad crown lengthening procedure. The dentist removed Too much tissue. I dont have gum diease, and bone wasnt removed. There was a cavity and hole in my old crown. I am very devestaed at the results. There are large gaps and spaces now. It is visible since its in the front. Iam wearing a temporary crown now and it looks really bad. It is too long. I didnt accept the permanent crown back because it was even bigger. Is there any way possible to do a cosmetic gum graft before or after the permanet crown is placed Above the tooth. I dont want the tooth to look as long and big as it does now. Thanks so much, I hope you can help.

Answer:

If the bone was not removed during surgery, there is a possibility to increase the amount of soft tissue and/or cut some from the adjacent tooth to match things.  I am thinking more towards the second option since you are giving me a  history of presence of decay under the previous restoration. The decay was probably extending towards the root surface, and this is probably why you needed crown lengthening. Thus, you probably have or will have some type of restoration material in where you want more gum structure. The graft will not bind on restorative material. Thus, it would be impossible to cover that part.  I recommend that you have a consultation appointment with a periodontist. She/he will evaluate the situation and tell you what can be done to improve the aesthetics prior to permanent crown placement.

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Response by:

Binnaz   Leblebicioglu, DDS, MS, PhD Binnaz Leblebicioglu, DDS, MS, PhD
Associate Professor of Periodontology
College of Dentistry
The Ohio State University