{"id":1670,"date":"2025-07-24T14:14:48","date_gmt":"2025-07-24T14:14:48","guid":{"rendered":"https:\/\/amdentalstudiogdl.mx\/?p=1670"},"modified":"2025-10-13T15:34:10","modified_gmt":"2025-10-13T15:34:10","slug":"por-que-a-veces-el-diente-necesita-mas-corona-para-salvarse","status":"publish","type":"post","link":"https:\/\/amdentalstudiogdl.mx\/en\/por-que-a-veces-el-diente-necesita-mas-corona-para-salvarse\/","title":{"rendered":"Why Sometimes a Tooth Needs \"More Crown\" to Be Saved"},"content":{"rendered":"

When a tooth fractures below the gumline, or decay spreads silently beneath the gingival margin, the issue isn\u2019t just removing the infection anymore: there\u2019s no visible healthy surface to seal a restoration<\/strong>. \nIn these cases, clinical crown lengthening becomes the difference between placing a well-fitted crown\u2026 or losing the tooth altogether.<\/p>\n\n\n\n

In the literature, it\u2019s defined as a periodontal surgery that repositions the gum margin and, if needed, reshapes bone<\/strong> to expose more of the tooth without invading the biological width. \nBut that technical definition doesn\u2019t capture its real significance: we\u2019re talking about preserving strong, healthy roots and avoiding extraction followed by implant placement.<\/p>\n\n\n\n

Over the years in my practice, I\u2019ve seen \u201cdoomed\u201d teeth come back to life thanks to this procedure. \nAnd I\u2019ve summed it up in my own words \u2014 words I\u2019ll repeat more than once, because they\u2019re the heart of this article:<\/p>\n\n\n\n

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\u201cClinical crown lengthening is used to expose healthy tooth structure in the coronal area so we can restore it\u2026 it\u2019s the last resort when a tooth is seriously compromised; we need supragingival healthy tissue to place a crown, an inlay \u2014 whatever the case may be.\u201d<\/em><\/p>\n<\/blockquote>\n\n\n\n

With that experience as our guiding thread, we\u2019ll explore what this technique really involves, when it\u2019s indicated, and how it\u2019s performed \u2014 so you\u2019ll know if it\u2019s truly your best option before someone suggests extracting the tooth.<\/p>\n\n\n\n

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2. Clinical Crown Lengthening: What It Really Is and How I Perform It<\/h2>\n\n\n\n
\"Alargamiento<\/figure>\n\n\n\n

In periodontal terms, crown lengthening is a flap surgery<\/strong>: I lift the gum, remove excess soft tissue, and when the root is still covered by bone, I eliminate between 1 and 3 mm of alveolar bone using high-irrigation burs. The goal is twofold: to move the gingival margin apically and preserve the biological space<\/strong> (\u2248 3 mm) without compromising gum attachment.<\/p>\n\n\n\n

My protocol includes:<\/p>\n\n\n\n

    \n
  1. Three-dimensional diagnosis<\/strong> using CBCT and probing to measure the distance between the cementoenamel junction and the bone.<\/li>\n\n\n\n
  2. Gingival design<\/strong>: I outline the new contour with a surgical pencil, preserving the papillae.<\/li>\n\n\n\n
  3. Intrasulcular incision<\/strong> and full-thickness flap<\/strong> down to the mucogingival junction.<\/li>\n\n\n\n
  4. Selective bone resection while keeping roots moist with cold saline.<\/li>\n\n\n\n
  5. 5-0 monofilament suture<\/strong> and a compress with hemostatic gel.<\/li>\n<\/ol>\n\n\n\n

    In the vast majority of cases, I\u2019m able to reposition the papillae intact, achieving a stable and aesthetic result. \nPost-op care includes anti-inflammatory medication for 48 hours, 0.12% chlorhexidine rinse for one week, and suture removal on day ten. \nBy the two-month mark, the tissue is stable and I can take impressions for the final crown.<\/p>\n\n\n\n

    \n\n\n\n

    3. When It\u2019s Indicated: Deep Cavities, Fractures, and Challenging Subgingival Margins<\/h2>\n\n\n\n

    The classic indications align with what the literature describes and what I\u2019ve consistently seen in practice:<\/p>\n\n\n\n