Board Certified Periodontist, Dr. Scott O. Kissel

Cosmetic Crown Lengthening – Case Study

Cosmetic Crown Lengthening before and after photos of a young woman

Table of Contents

Many patients come to my Manhattan, NYC, periodontal office to reduce the amount of gum tissue displayed when smiling.  This procedure is commonly called cosmetic crown lengthening (CCL). In this specific case, the surgery entailed making an incision between the tooth and gum without removing any gum tissue. The gum tissue is lifted above the teeth and off the bone.  This is followed by a bone reduction around all teeth and then the gum tissue is precisely positioned back to its original location. CCL can dramatically improve a patient’s smile with little to no discomfort. In fact, most patients wonder why they have not had the procedure performed sooner.

Why Patients Choose Our Practice

There are specific reasons patients are referred to our practice for CCL.  Our practice is unique in that for this procedure we employ microsurgical techniques, instruments, and philosophy.  This means I operate under a surgical microscope utilizing the highest level of magnification and illumination. This allows me to perform the most minimally invasive care, with little to no trauma to tissues, fewer complications, greater safety, greater accuracy, rapid healing, and little to no discomfort.

The Patient

In the patient’s case presented below, the referring doctor elected to first sculpt the gum tissue to the desired height and then place temporary veneers over the teeth (cover both tooth and an exposed root). This sequence requires a more technically demanding surgical procedure (not more pain) and temporary veneers designed with specific requirements

The reasons to first place temporary veneers are:

  • the patient’s new tooth length is created and defined prior to surgery
  • any exposed root surface is covered by the veneer
  • the tooth appears as one shade (roots are darker in appearance than the tooth)
  • the tissue heals conforming to the shape of the veneer
Cosmetic Crown Lengthening before and after photos of a young woman
Click on the image for a full-size view.

The one-week post-surgical photograph shows gum tissue that appears almost untouched with very little inflammation. The sutures are also clear making it less likely other people will notice that you’ve just had oral surgery.  This appearance is not common with traditional techniques.  Typically with traditional techniques, healing does not progress as rapidly as with microsurgical care. The tissue will frequently look red, inflamed, and not confluent with surrounding tissues.  With microsurgical care, at one week it appears as if little to no treatment was performed.

Cosmetic crown lengthening one-week post-surgical photo shows gum tissue that appears almost untouched and very little inflammation or discoloration is present.
Cosmetic crown lengthening one-week post-surgical photo shows gum tissue that appears almost untouched and very little inflammation or discoloration is present.

All in all, this is a very manageable procedure for patients and the immediate results are very exciting.

If you are considering crown lengthening for restorative or cosmetic reasons, schedule your consultation at my Madison Avenue periodontal office located between E 52nd St. and E 53rd St.

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