Single Tooth Crown Lengthening: Reasons for Referral

Objective: Crown lengthening surgery is a common and predictable periodontal procedure that is indicated for several reasons. This study aimed to assess the reasons for referral for crown lengthening surgery.

Method: This was a retrospective study conducted in a University periodontal clinic setting. Charts of patients consecutively referred for and treated with crown lengthening surgery on a single tooth during a 15-month period were reviewed. Patient demographics and reasons for referral, along with dental history of treated tooth were recorded.

Result: There were 71 cases identified and included in this report. The patients were mostly Caucasian (86%) and female (61%) with an average age of 51 years. Subgingival caries (65% of referred teeth), crown fracture (18%), caries below the bone crest level (13%), caries in furcation area (6%) and root fracture (6%) were the most common reasons for referral. The dental history of referred teeth included previous restoration (86%), previous endodontic therapy (35%), and previous periodontal therapy (27%). Only 7% of the referred teeth served as abutments for fixed partial dentures. Maxillary teeth were much more frequent (61%), while the most commonly referred teeth were molars (55%) and incisors/canines (25%). Left (51%) and right (49%) side of the mouth were equally represented. There was a strong association between crown fracture and previous endodontic therapy (p=0.05; 62% of teeth with crown fracture had had root canal treatment).

Conclusion: The results of this study indicate that subgingival caries and fracture are the predominant reasons for single tooth crown lengthening referral in this population, with posterior teeth representing two thirds of the referred cases. These results suggest that referring clinics commonly consider periodontal services in the course of the restorative management of such teeth.